DIVERSICARE OF BRADFORD PLACE
LOCATED: 1302 MILLVILLE AVENUE, HAMILTON, OH 45013
DIVERSICARE OF BRADFORD PLACE was cited by the DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES for the following deficiencies:
PLEASE NOTE: The following highlighted quoted text is only a portion of the full report/survey submitted by DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES. The full report/survey can be found here.
FACILITY FAILED TO PREVENT AVOIDABLE IN-HOUSE ACQUIRED PRESSURE ULCERS
LEVEL OF HARM – IMMEDIATE JEOPARDY
RESIDENTS AFFECTED – MANY
**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY**
Based on medical record review, observation, resident and staff interview, facility policy review and review of documentation from the National Pressure Ulcer Advisory Panel (NPUAP), the facility failed to implement interventions to prevent avoidable in-house acquired pressure ulcers and failed to identify multiple avoidable pressure ulcers until they were either Stage III or unstageable (blackened in color with necrotic tissue). This resulted in Immediate Jeopardy for five (#103, #2, #81, #133, #143) of eight residents reviewed for pressure ulcers. The facility identified seven residents with in-house acquired pressure ulcers. This had the potential to affect all residents in the facility. The facility census was 72. On 02/13/14 at 11:21 A.M., Regional Vice President #3, Director of Clinical Operations #5 and the Director of Nursing (DON) were notified Immediate Jeopardy began on 09/08/13, when Resident #103 was found with an avoidable, unstageable blackened pressure ulcer to the left heel. In addition, Resident #2 was found with an avoidable, unstageable pressure ulcer to the right heel on 01/02/14; Resident #81 was found with avoidable, unstageable pressure ulcers to the right and left heel on 02/03/14; Resident #133 was found with an avoidable Stage III pressure ulcer to the left ischium on 02/05/14; and Resident #143 was found with an avoidable, unstageable pressure ulcer to the left heel on 02/05/14. There were no documented measures to prevent skin breakdown implemented for any of the five residents prior to the facility’s discovery of either Stage III or unstageable pressure ulcers.
Personal Note from NHAA Advocates: NHAA shares with all the families of loved ones who are confined to nursing homes the pain and anguish of putting them in the care of someone else. We expect our loved ones to be treated with dignity and honor in the homes we place them. We cannot emphasize enough to family members of nursing home residents; frequent visits are essential to our loved ones’ well-being and safety. This nursing home and many others across the country are cited for abuse and neglect.
You can make a difference. If you have a loved one living in this nursing home or any other nursing home where you suspect any form of abuse or neglect, contact us immediately. We can help you file a state complaint, hire a specialized nursing home attorney or help you find a more suitable location for your loved one.
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